Thousands who ‘followed the rules’ are about to get covid. They shouldn’t be ashamed.
"Aline is part of a rapid uptick in cases in the United States. As two variants collide and states hit new records daily, breakthrough cases are becoming more normal and less of an exception; the Centers for Disease Control and Prevention warns these cases are now “likely” to occur. For many people who test positive during this latest surge, the virus is sparking yet another unpleasant feeling in an ordeal that’s churned out plenty: shame.
“There’s been this large narrative about the importance of controlling your actions to prevent yourself from getting sick, and from transmitting the illness to other people,” says Jessica Stern, a clinical psychologist at NYU Langone Health. “Because the narrative is so closely connected to our behaviors, I think there’s this implication, or this assumption, that if you get sick, you must have done something wrong to bring it onto yourself.” That’s not true, she stresses, “but unfortunately it’s inherent in the way we’ve been thinking about and talking about covid.” That can lead to shame, which Stern defines as “the combination of embarrassment or guilt and identity — one of the most visceral emotions.”
Health officials have stressed that it’s crucial to be fully vaccinated and boosted, and to get tested frequently. But even those safeguards aren’t a guarantee against infection:For the week ending Dec. 11, Massachusetts, one of the most highly vaccinated states with 74 percent fully immunized, reported 11,431 breakthrough infections, about 37 percent of its total new positive cases. Sports leagues are canceling games due to outbreaks among vaccinated players, and “Saturday Night Live” scrapped its most recent show because of fears about the virus.
“It’s important to understand that with the omicron variant, we’re facing a virus that is more transmissible than delta, and in turn delta more transmissible than alpha and so forth,” says Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. Some people have misunderstood the role vaccines play in preventing illness, believing that they protect against any and all infection. That’s not the case. As Hotez points out, just two to three months after getting the Pfizer booster, protection against symptomatic infection from omicron drops from around 70-75 percent to 30-40 percent. “The bottom line is that getting infected with omicron could now happen to anyone,” he says.
The sense of shame that can come with a coronavirus diagnosis isn’t surprising, says Lynn Bufka, a senior director at the American Psychological Association and a practicing licensed clinical psychologist in Maryland. “Shame has a history of being connected to various health diagnoses,” she says, such as HIV and even, for decades, cancer. “It comes from thinking that you’re being seen and judged by others, and gosh, look around. The reality is that there’s a lot of judging about people who have covid, so it’s understandable that they might feel some shame.”
Bufka follows the FacesOfCOVID Twitter account, which shares photos of and stories about those lost to the virus. “It makes me cry almost every single time because these are somebody's loved ones who died,” she says. Yet it’s easy to start wondering: Was that person vaccinated? How and why did they get sick? Bufka reminds herself: “That’s not the point. The point is, somebody had a really terrible illness, and they died from it.”
Kelly Michelson, an attending physician at the Ann & Robert H. Lurie Children’s Hospital of Chicago and director of the Center for Bioethics and Medical Humanities at Northwestern University Feinberg School of Medicine, often takes care of patients who get sick for reasons they theoretically could have prevented. “My place is to just see the patient and help the patient, and not make assumptions about why people make certain choices in their lives,” she says, which is helpful advice to anyone who might judge others who test positive for the coronavirus. Doing so would be “making an assumption about some things that we just don’t know,” she says.
Feeling ashamed about getting covid-19 isn’t healthy or helpful, experts agree. Here are some tips on how to clamp down on those feelings.
Acknowledge it. “As a psychologist, we’re going to tell people: Acknowledge the emotion,” Bufka says. “Try to recognize what it is. We know we’re in an environment right now where there’s a lot of judgment,” and it makes sense that you might be feeling, well, mortified at the idea that others will think you behaved carelessly.
Sue Varma, a psychiatrist in New York, suggests tapping into some self-awareness about where the shame is coming from: Do you have perfectionist standards? Or was staying healthy your way of regaining control during an impossibly trying stretch of time? Reflecting on the reasons you feel ashamed can help you come to terms with the emotion and, ultimately, move past it.
Set it aside in favor of proper health protocols. Research indicates that shame often prevents people who have HIV from disclosing all the relevant facts — to their partners, for example. Bufka says it’s reasonable to believe the same thing is playing out now: “It can prevent people from getting the health care that they need, or telling their contacts” about the potential exposure, which is concerning. She urges those who have tested positive for the coronavirus to focus on “what behavior is going to be best for your health, and for the people around you.”
That said, don’t over-explain the situation. If you’re ashamed of your coronavirus diagnosis, you might be tempted to over-explain it to others, Stern says — and “maybe even be preemptively defensive,” immediately telling people who didn’t ask that you had taken safety protocols seriously. As much as possible, avoid the urge. Stern suggests framing any explanation in a short, lighthearted manner: “I’m super careful, but it got me!”
Consider it a learning experience. “I hate to say we’re in this for the long run, but this is like a long game here,” Varma says. In many cases, getting covid might have happened despite extreme caution — she knows someone whose daughter recently contracted the virus from her school bus driver, for example. But perhaps, in your desperation to return to normal life, you’ve been less than careful. In that case, see what you can learn from the experience. As Varma puts it: “Maybe not going to the nightclubs anymore, right?”
Or perhaps you don’t wear a mask often. Use this as an opportunity to create a strategy you can use going forward, Bufka suggests: Go online and order a whole bunch of masks, and then “put them everywhere” — in your car, in your purse, in a coat jacket, on the table where you set your keys and mail. And, of course, if you haven’t yet gotten vaccinated or have delayed seeking out a booster shot, go do so, Bufka says.
Keep in mind that you can’t control what others do or think. “There are some people who are going to act like jerks, and we all have to live with that,” says Jonathan S. Abramowitz, a professor of psychology in the University of North Carolina clinical psychology program. “See it for what it is. By all means, don’t say, ‘Well, this person is making me feel ashamed, so therefore they’re right and I should feel ashamed.’” And if your friends are making you feel bad about your diagnosis, perhaps it’s time to reconsider the company you keep, Abramowitz says.
Practice self-compassion. Perhaps easier said than done, but it’s important, especially given that you’re also dealing with a serious virus. First, if you’re ruminating over everything you wish you had done differently, flip your perspective and consider: “It could be that you’re very diligent and very conscientious, and that’s why you’re taking this so hard,” Varma says. “That just means you’re a thoughtful, considerate, caring human being trying really, really hard.”
As Bufka points out, second-guessing ourselves isn’t productive. Did you forget to wear your mask that one time at the grocery store? Should you have canceled dinner with friends? It’s a moot point by now. “I’ve lived long enough to know that reliving things I did in the past, and trying to figure out a better way to have done them, rarely changes those events,” she says.
Remember: You’re not a failure. “Millions of other people have gotten sick,” Varma says. “Unfortunately, you’re not alone. You’re not the only one. You’re not the first one to get covid, and you won’t be the last.” And that positive test, she reiterates, “doesn’t make you an irresponsible person.”